Skip to main content
Top
Published in: BMC Infectious Diseases 1/2014

Open Access 01-12-2014 | Research article

Detection of a novel avian influenza A (H7N9) virus in humans by multiplex one-step real-time RT-PCR assay

Authors: Jian Fan, David Cui, Siuying Lau, Guoliang Xie, Xichao Guo, Shufa Zheng, Xiaofeng Huang, Shigui Yang, Xianzhi Yang, Zhaoxia Huo, Fei Yu, Jianzhou Lou, Li Tian, Xuefen Li, Yuejiao Dong, Qiaoyun Zhu, Yu Chen

Published in: BMC Infectious Diseases | Issue 1/2014

Login to get access

Abstract

Background

A novel avian influenza A (H7N9) virus emerged in eastern China in February 2013. 413 confirmed human cases, including 157 deaths, have been recorded as of July 31, 2014.

Methods

Clinical specimens, including throat swabs, sputum or tracheal aspirates, etc., were obtained from patients exhibiting influenza-like illness (ILIs), especially from those having pneumonia and a history of occupational exposure to poultry and wild birds. RNA was extracted from these samples and a multiplex one-step real-time RT-PCR assay was developed to specifically detect the influenza A virus (FluA). PCR primers targeted the conserved M and Rnase P (RP) genes, as well as the hemagglutinin and neuraminidase genes of the H7N9 virus.

Results

The multiplex assay specifically detected the avian H7N9 virus, and no cross-reaction with other common respiratory pathogens was observed. The detection limit of the assay was approximately 0.05 50% tissue culture infective doses (TCID50), or 100 copies per reaction. Positive detection of the H7N9 virus in sputum/tracheal aspirates was higher than in throat swabs during the surveillance of patients with ILIs. Additionally, detection of the matrix (M) and Rnase P genes aided in the determination of the novel avian H7N9 virus and ensured the quality of the clinical samples.

Conclusions

These results demonstrate that the multiplex assay detected the novel avian H7N9 virus with high specificity and sensitivity, which is essential for the early diagnosis and treatment of infected patients.
Appendix
Available only for authorised users
Literature
1.
go back to reference Chen Y, Cui D, Zheng S, Yang S, Tong J, Yang D, Fan J, Zhang J, Lou B, Li X, Zhuge X, Ye B, Chen B, Mao W, Tan Y, Xu G, Chen Z, Chen N, Li L: Simultaneous detection of influenza A, influenza B, and respiratory syncytial viruses and subtyping of influenza A H3N2 virus and H1N1 (2009) virus by multiplex real-time PCR. J Clin Microbiol. 2011, 49 (4): 1653-1656. 10.1128/JCM.02184-10.CrossRefPubMedPubMedCentral Chen Y, Cui D, Zheng S, Yang S, Tong J, Yang D, Fan J, Zhang J, Lou B, Li X, Zhuge X, Ye B, Chen B, Mao W, Tan Y, Xu G, Chen Z, Chen N, Li L: Simultaneous detection of influenza A, influenza B, and respiratory syncytial viruses and subtyping of influenza A H3N2 virus and H1N1 (2009) virus by multiplex real-time PCR. J Clin Microbiol. 2011, 49 (4): 1653-1656. 10.1128/JCM.02184-10.CrossRefPubMedPubMedCentral
2.
go back to reference Dong H, Zhang Y, Xiong H, Yan A, Ding G, Chen Y, Xie L, Chen J, Zhang G, Hao P, Cong L, Lu Y, Che X, Wang X, Li Y, Yuen KY, Zhao G, Jin W: Detection of human novel influenza A (H1N1) viruses using multi-fluorescent real-time RT-PCR. Virus Res. 2010, 147 (1): 85-90. 10.1016/j.virusres.2009.10.011.CrossRefPubMed Dong H, Zhang Y, Xiong H, Yan A, Ding G, Chen Y, Xie L, Chen J, Zhang G, Hao P, Cong L, Lu Y, Che X, Wang X, Li Y, Yuen KY, Zhao G, Jin W: Detection of human novel influenza A (H1N1) viruses using multi-fluorescent real-time RT-PCR. Virus Res. 2010, 147 (1): 85-90. 10.1016/j.virusres.2009.10.011.CrossRefPubMed
3.
go back to reference Kudo K, Binh NG, Manabe T, Co DX, Tuan ND, Izumi S, Takasaki J, Minh DH, Thuy PT, Van VT, Hanh TT, Chau NQ: Clinical preparedness for severe pneumonia with highly pathogenic avian influenza A (H5N1): experiences with cases in Vietnam. Respir Investig. 2012, 50 (4): 140-150. 10.1016/j.resinv.2012.08.005.CrossRefPubMed Kudo K, Binh NG, Manabe T, Co DX, Tuan ND, Izumi S, Takasaki J, Minh DH, Thuy PT, Van VT, Hanh TT, Chau NQ: Clinical preparedness for severe pneumonia with highly pathogenic avian influenza A (H5N1): experiences with cases in Vietnam. Respir Investig. 2012, 50 (4): 140-150. 10.1016/j.resinv.2012.08.005.CrossRefPubMed
4.
go back to reference Kim HR, Park CK, Lee YJ, Oem JK, Kang HM, Choi JG, Lee OS, Bae YC: Low pathogenic H7 subtype avian influenza viruses isolated from domestic ducks in South Korea and the close association with isolates of wild birds. J Gen Virol. 2012, 93 (Pt 6): 1278-1287.CrossRefPubMed Kim HR, Park CK, Lee YJ, Oem JK, Kang HM, Choi JG, Lee OS, Bae YC: Low pathogenic H7 subtype avian influenza viruses isolated from domestic ducks in South Korea and the close association with isolates of wild birds. J Gen Virol. 2012, 93 (Pt 6): 1278-1287.CrossRefPubMed
5.
go back to reference Ostrowsky B, Huang A, Terry W, Anton D, Brunagel B, Traynor L, Abid S, Johnson G, Kacica M, Katz J, Edwards L, Lindstrom S, Klimov A, Uyeki TM: Low pathogenic avian influenza A (H7N2) virus infection in immunocompromised adult, New York, USA, 2003. Emerg Infect Dis. 2012, 18 (7): 1128-1131. 10.3201/eid1807.111913.CrossRefPubMedPubMedCentral Ostrowsky B, Huang A, Terry W, Anton D, Brunagel B, Traynor L, Abid S, Johnson G, Kacica M, Katz J, Edwards L, Lindstrom S, Klimov A, Uyeki TM: Low pathogenic avian influenza A (H7N2) virus infection in immunocompromised adult, New York, USA, 2003. Emerg Infect Dis. 2012, 18 (7): 1128-1131. 10.3201/eid1807.111913.CrossRefPubMedPubMedCentral
6.
go back to reference Koopmans M, Wilbrink B, Conyn M, Natrop G, van der Nat H, Vennema H, Meijer A, van Steenbergen J, Fouchier R, Osterhaus A, Bosman A: Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands. Lancet. 2004, 363 (9409): 587-593. 10.1016/S0140-6736(04)15589-X.CrossRefPubMed Koopmans M, Wilbrink B, Conyn M, Natrop G, van der Nat H, Vennema H, Meijer A, van Steenbergen J, Fouchier R, Osterhaus A, Bosman A: Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands. Lancet. 2004, 363 (9409): 587-593. 10.1016/S0140-6736(04)15589-X.CrossRefPubMed
7.
go back to reference Chen H, Yuan H, Gao R, Zhang J, Wang D, Xiong Y, Fan G, Yang F, Li X, Zhou J, Zou S, Yang L, Chen T, Dong L, Bo H, Zhao X, Zhang Y, Lan Y, Bai T, Dong J, Li Q, Wang S, Zhang Y, Li H, Gong T, Shi Y, Ni X, Li J, Zhou J, Fan J: Clinical and epidemiological characteristics of a fatal case of avian influenza A H10N8 virus infection: a descriptive study. Lancet. 2014, 383 (9918): 714-721. 10.1016/S0140-6736(14)60111-2.CrossRefPubMed Chen H, Yuan H, Gao R, Zhang J, Wang D, Xiong Y, Fan G, Yang F, Li X, Zhou J, Zou S, Yang L, Chen T, Dong L, Bo H, Zhao X, Zhang Y, Lan Y, Bai T, Dong J, Li Q, Wang S, Zhang Y, Li H, Gong T, Shi Y, Ni X, Li J, Zhou J, Fan J: Clinical and epidemiological characteristics of a fatal case of avian influenza A H10N8 virus infection: a descriptive study. Lancet. 2014, 383 (9918): 714-721. 10.1016/S0140-6736(14)60111-2.CrossRefPubMed
8.
go back to reference Arzey GG, Kirkland PD, Arzey KE, Frost M, Maywood P, Conaty S, Hurt AC, Deng YM, Iannello P, Barr I, Dwyer DE, Ratnamohan M, McPhie K, Selleck P: Influenza virus A (H10N7) in chickens and poultry abattoir workers, Australia. Emerg Infect Dis. 2012, 18 (5): 814-816. 10.3201/eid1805.111852.CrossRefPubMedPubMedCentral Arzey GG, Kirkland PD, Arzey KE, Frost M, Maywood P, Conaty S, Hurt AC, Deng YM, Iannello P, Barr I, Dwyer DE, Ratnamohan M, McPhie K, Selleck P: Influenza virus A (H10N7) in chickens and poultry abattoir workers, Australia. Emerg Infect Dis. 2012, 18 (5): 814-816. 10.3201/eid1805.111852.CrossRefPubMedPubMedCentral
9.
go back to reference Cheng VC, Chan JF, Wen X, Wu WL, Que TL, Chen H, Chan KH, Yuen KY: Infection of immunocompromised patients by avian H9N2 influenza A virus. J Infect. 2011, 62 (5): 394-399. 10.1016/j.jinf.2011.02.007.CrossRefPubMed Cheng VC, Chan JF, Wen X, Wu WL, Que TL, Chen H, Chan KH, Yuen KY: Infection of immunocompromised patients by avian H9N2 influenza A virus. J Infect. 2011, 62 (5): 394-399. 10.1016/j.jinf.2011.02.007.CrossRefPubMed
10.
go back to reference Gao HN, Lu HZ, Cao B, Du B, Shang H, Gan JH, Lu SH, Yang YD, Fang Q, Shen YZ, Xi XM, Gu Q, Zhou XM, Qu HP, Yan Z, Li FM, Zhao W, Gao ZC, Wang GF, Ruan LX, Wang WH, Ye J, Cao HF, Li XW, Zhang WH, Fang XC, He J, Liang WF, Xie J, Zeng M: Clinical findings in 111 cases of influenza A (H7N9) virus infection. N Engl J Med. 2013, 368 (24): 2277-2285. 10.1056/NEJMoa1305584.CrossRefPubMed Gao HN, Lu HZ, Cao B, Du B, Shang H, Gan JH, Lu SH, Yang YD, Fang Q, Shen YZ, Xi XM, Gu Q, Zhou XM, Qu HP, Yan Z, Li FM, Zhao W, Gao ZC, Wang GF, Ruan LX, Wang WH, Ye J, Cao HF, Li XW, Zhang WH, Fang XC, He J, Liang WF, Xie J, Zeng M: Clinical findings in 111 cases of influenza A (H7N9) virus infection. N Engl J Med. 2013, 368 (24): 2277-2285. 10.1056/NEJMoa1305584.CrossRefPubMed
11.
go back to reference Gao R, Cao B, Hu Y, Feng Z, Wang D, Hu W, Chen J, Jie Z, Qiu H, Xu K, Xu X, Lu H, Zhu W, Gao Z, Xiang N, Shen Y, He Z, Gu Y, Zhang Z, Yang Y, Zhao X, Zhou L, Li X, Zou S, Zhang Y, Li X, Yang L, Guo J, Dong J, Li Q: Human infection with a novel avian-origin influenza A (H7N9) virus. N Engl J Med. 2013, 368 (20): 1888-1897. 10.1056/NEJMoa1304459.CrossRefPubMed Gao R, Cao B, Hu Y, Feng Z, Wang D, Hu W, Chen J, Jie Z, Qiu H, Xu K, Xu X, Lu H, Zhu W, Gao Z, Xiang N, Shen Y, He Z, Gu Y, Zhang Z, Yang Y, Zhao X, Zhou L, Li X, Zou S, Zhang Y, Li X, Yang L, Guo J, Dong J, Li Q: Human infection with a novel avian-origin influenza A (H7N9) virus. N Engl J Med. 2013, 368 (20): 1888-1897. 10.1056/NEJMoa1304459.CrossRefPubMed
12.
go back to reference Liu T, Bi Z, Wang X, Li Z, Ding S, Bi Z, Wang L, Pei Y, Song S, Zhang S, Wang J, Sun D, Pang B, Sun L, Jiang X, Lei J, Yuan Q, Kou Z, Yang B, Shu Y, Yang L, Li X, Lu K, Liu J, Zhang T, Xu A: One family cluster of avian influenza A(H7N9) virus infection in Shandong, China. BMC Infect Dis. 2014, 14 (1): 98-10.1186/1471-2334-14-98.CrossRefPubMedPubMedCentral Liu T, Bi Z, Wang X, Li Z, Ding S, Bi Z, Wang L, Pei Y, Song S, Zhang S, Wang J, Sun D, Pang B, Sun L, Jiang X, Lei J, Yuan Q, Kou Z, Yang B, Shu Y, Yang L, Li X, Lu K, Liu J, Zhang T, Xu A: One family cluster of avian influenza A(H7N9) virus infection in Shandong, China. BMC Infect Dis. 2014, 14 (1): 98-10.1186/1471-2334-14-98.CrossRefPubMedPubMedCentral
14.
go back to reference Wong CK, Zhu H, Li OT, Leung YH, Chan MC, Guan Y, Peiris JS, Poon LL: Molecular detection of human H7N9 influenza A virus causing outbreaks in China. Clin Chem. 2013, 59 (7): 1062-1067. 10.1373/clinchem.2013.208975.CrossRefPubMed Wong CK, Zhu H, Li OT, Leung YH, Chan MC, Guan Y, Peiris JS, Poon LL: Molecular detection of human H7N9 influenza A virus causing outbreaks in China. Clin Chem. 2013, 59 (7): 1062-1067. 10.1373/clinchem.2013.208975.CrossRefPubMed
15.
go back to reference Li Q, Zhou L, Zhou M, Chen Z, Li F, Wu H, Xiang N, Chen E, Tang F, Wang D, Meng L, Hong Z, Tu W, Cao Y, Li L, Ding F, Liu B, Wang M, Xie R, Gao R, Li X, Bai T, Zou S, He J, Hu J, Xu Y, Chai C, Wang S, Gao Y, Jin L: Epidemiology of human infections with avian influenza A(H7N9) virus in China. N Engl J Med. 2014, 370 (6): 520-532. 10.1056/NEJMoa1304617.CrossRefPubMed Li Q, Zhou L, Zhou M, Chen Z, Li F, Wu H, Xiang N, Chen E, Tang F, Wang D, Meng L, Hong Z, Tu W, Cao Y, Li L, Ding F, Liu B, Wang M, Xie R, Gao R, Li X, Bai T, Zou S, He J, Hu J, Xu Y, Chai C, Wang S, Gao Y, Jin L: Epidemiology of human infections with avian influenza A(H7N9) virus in China. N Engl J Med. 2014, 370 (6): 520-532. 10.1056/NEJMoa1304617.CrossRefPubMed
16.
go back to reference Lu S, Xi X, Zheng Y, Cao Y, Liu X, Lu H: Analysis of the clinical characteristics and treatment of two patients with avian influenza virus (H7N9). Biosci Trends. 2013, 7 (2): 109-112.PubMed Lu S, Xi X, Zheng Y, Cao Y, Liu X, Lu H: Analysis of the clinical characteristics and treatment of two patients with avian influenza virus (H7N9). Biosci Trends. 2013, 7 (2): 109-112.PubMed
17.
go back to reference Chen Y, Liang W, Yang S, Wu N, Gao H, Sheng J, Yao H, Wo J, Fang Q, Cui D, Li Y, Yao X, Zhang Y, Wu H, Zheng S, Diao H, Xia S, Zhang Y, Chan KH, Tsoi HW, Teng JL, Song W, Wang P, Lau SY, Zheng M, Chan JF, To KK, Chen H, Li L, Yuen KY: Human infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genome. Lancet. 2013, 381 (9881): 1916-1925. 10.1016/S0140-6736(13)60903-4.CrossRefPubMed Chen Y, Liang W, Yang S, Wu N, Gao H, Sheng J, Yao H, Wo J, Fang Q, Cui D, Li Y, Yao X, Zhang Y, Wu H, Zheng S, Diao H, Xia S, Zhang Y, Chan KH, Tsoi HW, Teng JL, Song W, Wang P, Lau SY, Zheng M, Chan JF, To KK, Chen H, Li L, Yuen KY: Human infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genome. Lancet. 2013, 381 (9881): 1916-1925. 10.1016/S0140-6736(13)60903-4.CrossRefPubMed
18.
go back to reference Guan Y, Farooqui A, Zhu H, Dong W, Wang J, Kelvin DJ: H7N9 Incident, immune status, the elderly and a warning of an influenza pandemic. J Infect Dev Ctries. 2013, 7 (4): 302-307.CrossRefPubMed Guan Y, Farooqui A, Zhu H, Dong W, Wang J, Kelvin DJ: H7N9 Incident, immune status, the elderly and a warning of an influenza pandemic. J Infect Dev Ctries. 2013, 7 (4): 302-307.CrossRefPubMed
19.
go back to reference Corman VM, Eickmann M, Landt O, Bleicker T, Brunink S, Eschbach-Bludau M, Matrosovich M, Becker S, Drosten C: Specific detection by real-time reverse-transcription PCR assays of a novel avian influenza A(H7N9) strain associated with human spillover infections in China. Euro Surveill. 2013, 18 (16): 20461-PubMed Corman VM, Eickmann M, Landt O, Bleicker T, Brunink S, Eschbach-Bludau M, Matrosovich M, Becker S, Drosten C: Specific detection by real-time reverse-transcription PCR assays of a novel avian influenza A(H7N9) strain associated with human spillover infections in China. Euro Surveill. 2013, 18 (16): 20461-PubMed
20.
go back to reference Zhang Y, Mao H, Yan J, Wang X, Zhang L, Guus K, Li H, Li Z, Chen Y, Gong L, Chen Z, Xia S: Development of novel AllGlo-probe-based one-step multiplex qRT-PCR assay for rapid identification of avian influenza virus H7N9. Arch Virol. 2014, 159 (7): 1707-1713. 10.1007/s00705-014-1979-5.CrossRefPubMed Zhang Y, Mao H, Yan J, Wang X, Zhang L, Guus K, Li H, Li Z, Chen Y, Gong L, Chen Z, Xia S: Development of novel AllGlo-probe-based one-step multiplex qRT-PCR assay for rapid identification of avian influenza virus H7N9. Arch Virol. 2014, 159 (7): 1707-1713. 10.1007/s00705-014-1979-5.CrossRefPubMed
21.
go back to reference Zhu Z, Fan H, Qi X, Qi Y, Shi Z, Wang H, Cui L, Zhou M: Development and evaluation of a SYBR green-based real time RT-PCR assay for detection of the emerging avian influenza A (H7N9) virus. PLoS One. 2013, 8 (11): e80028-10.1371/journal.pone.0080028.CrossRefPubMedPubMedCentral Zhu Z, Fan H, Qi X, Qi Y, Shi Z, Wang H, Cui L, Zhou M: Development and evaluation of a SYBR green-based real time RT-PCR assay for detection of the emerging avian influenza A (H7N9) virus. PLoS One. 2013, 8 (11): e80028-10.1371/journal.pone.0080028.CrossRefPubMedPubMedCentral
22.
go back to reference Zhang J, Feng Y, Hu D, Lv H, Zhu J, Cao M, Zheng F, Zhu J, Gong X, Hao L, Srinivas S, Ren H, Qi Z, Li B, Wang C: Rapid and sensitive detection of H7N9 avian influenza virus by use of reverse transcription-loop-mediated isothermal amplification. J Clin Microbiol. 2013, 51 (11): 3760-3764. 10.1128/JCM.01907-13.CrossRefPubMedPubMedCentral Zhang J, Feng Y, Hu D, Lv H, Zhu J, Cao M, Zheng F, Zhu J, Gong X, Hao L, Srinivas S, Ren H, Qi Z, Li B, Wang C: Rapid and sensitive detection of H7N9 avian influenza virus by use of reverse transcription-loop-mediated isothermal amplification. J Clin Microbiol. 2013, 51 (11): 3760-3764. 10.1128/JCM.01907-13.CrossRefPubMedPubMedCentral
23.
go back to reference Ge Y, Wu B, Qi X, Zhao K, Guo X, Zhu Y, Qi Y, Shi Z, Zhou M, Wang H, Cui L: Rapid and sensitive detection of novel avian-origin influenza A (H7N9) virus by reverse transcription loop-mediated isothermal amplification combined with a lateral-flow device. PLoS One. 2013, 8 (8): e69941-10.1371/journal.pone.0069941.CrossRefPubMedPubMedCentral Ge Y, Wu B, Qi X, Zhao K, Guo X, Zhu Y, Qi Y, Shi Z, Zhou M, Wang H, Cui L: Rapid and sensitive detection of novel avian-origin influenza A (H7N9) virus by reverse transcription loop-mediated isothermal amplification combined with a lateral-flow device. PLoS One. 2013, 8 (8): e69941-10.1371/journal.pone.0069941.CrossRefPubMedPubMedCentral
24.
go back to reference Nie K, Zhao X, Ding X, Li XD, Zou SM, Guo JF, Wang DY, Gao RB, Li XY, Huang WJ, Shu YL, Ma XJ: Visual detection of human infection with influenza A (H7N9) virus by subtype-specific reverse transcription loop-mediated isothermal amplification with hydroxynaphthol blue dye. Clin Microbiol Infect. 2013, 19 (8): E372-E375. 10.1111/1469-0691.12263.CrossRefPubMed Nie K, Zhao X, Ding X, Li XD, Zou SM, Guo JF, Wang DY, Gao RB, Li XY, Huang WJ, Shu YL, Ma XJ: Visual detection of human infection with influenza A (H7N9) virus by subtype-specific reverse transcription loop-mediated isothermal amplification with hydroxynaphthol blue dye. Clin Microbiol Infect. 2013, 19 (8): E372-E375. 10.1111/1469-0691.12263.CrossRefPubMed
Metadata
Title
Detection of a novel avian influenza A (H7N9) virus in humans by multiplex one-step real-time RT-PCR assay
Authors
Jian Fan
David Cui
Siuying Lau
Guoliang Xie
Xichao Guo
Shufa Zheng
Xiaofeng Huang
Shigui Yang
Xianzhi Yang
Zhaoxia Huo
Fei Yu
Jianzhou Lou
Li Tian
Xuefen Li
Yuejiao Dong
Qiaoyun Zhu
Yu Chen
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2014
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-14-541

Other articles of this Issue 1/2014

BMC Infectious Diseases 1/2014 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine